一位糖尿病截肢手術病患之護理經驗

本文係探討協助一位68歲罹患糖尿病，面對左膝下截肢，引發身體功能受損及心理衝擊之護理經驗。筆者於照護期間（96年11月20日至12月6日），運用Gordon十一項功能性健康型態評估工具，藉由直接護理、觀察、會談等技巧收集資料，確立主要護理問題有急性疼痛、身體心像紊亂、身體活動功能障礙與知識缺失。護理過程中筆者以傾聽、主動關懷鼓勵個案說出心中感受，並與個案建立良好護病關係，鼓勵家屬參與治療過程，協助個案了解及適應此疾病帶來之巨大改變，提供個別性、連續性之身心照顧，使其在生理、心理、社會與靈性方面得到良好調適，促進自我照顧能力，提升自我價值，並適應截肢的生活。冀望藉此護理經驗分享，提供護理人員重視截肢病人身心之調適，及做為日後照顧此類病人之參考。

關鍵字

糖尿病足；截肢；身體心像改變

並列摘要

This paper presents the experience of nursing a 68 year-old patient suffering from diabetes who had to cope with physical disability and mental anguish of undergoing a blow-knee amputation of his left leg. In the process of nursing this patient (from 1996/11/20 to 1996/12/6), the author adopted the Gordon's 11 Functional Health Patterns as the assessment method, collected information by physical examination and nursing, observation, and interview, and finally defined that the patient has the following aspects need to be specially cared including acute pain, body image distubance, physical activity dysfunction and lack of adequate knowledge. In the nursing period, the author actively listened to the patient's concerns and feelings, and established a very good nurse-patient relationship. Also the author encouraged his family to cooperate and participate in the treating process, to help the patient to get to know this disease and get used to the changed life. We provided an individual and continual care for his body and mind, and consequently make him well- balanced physically, mentally, socially and spiritually. We enhanced his self-care ability, and promoted his self-evaluation, which would help him to settle in the post-amputation life more quickly. Here I would like to share this experience and encourage nurses to pay more attention to a patient’s physical and mental status.